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3rd year dentistry > Head and Neck anatomy > Flashcards

Head and Neck anatomy Flashcards

1
Q

The tissue at the junction between the labial or buccal mucosa and the alveolar mucosa is the…

A

Mucobuccal fold

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2
Q

Name the four suprahyoid muscles

A

Digastric Mylohyoid Stylohyoid Geniohyoid

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3
Q

Name the four infrahyoid muscles

A

Omohyoid Sternohyoid Sternothyroid Thyrohyoid

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4
Q

Which paired muscles unite medially to form the floor of the mouth?

A

mylohyoid

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5
Q

Which muscle group serves to depress the hyoid bone?

A

Infrahyoid muscles

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6
Q

Which muscle group is involved in both elevating the hyoid bone and depressing the mandible?

A

suprahyoid muscles

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7
Q

What are the actions of the suprahyoid muscles?

A

Elevation of hyoid bone and larynx if mandible is stabilised by muscles of mastication

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8
Q

What are the actions of the anterior suprahyoid muscles?

A

Depress mandible and open jaws; mylohyoid forms floor of mouth and helps elevate tongue

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9
Q

Give the clinical applications of an emergency airway

A

The cricothyroid ligament may be pierced by a fine 1mm needle when a patient cannot breathe. An example of when this might happen is anaphylactic shock

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10
Q

Give the clinical applications of osteoma

A

This is a localised mass of bone which is a benign tumour. It may be found on the skull but is slow growing with no symptoms. If necessary it can be removed

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11
Q

Give the clinical applications of multiple myeloma

A

This is a tumour of the bone marrow cells and may also affect the skull

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12
Q

Give the clinical applications of Bells palsy

A

This is a unilateral paralysis of the facial nerve with no known cause

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13
Q

Give the clinical applications of an oro-antral fistula

A

some patients will have just a paperthin wall of bony tissue between their first molar and maxillary sinus. When extracting the first molar it may lead to this being broken and there being communication between the oral cavity and the maxillary sinus. When it closes it is lined with epithelial cells

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14
Q

What are the clinical applications of referred pain from toothache?

A

There may be referred pain from toothache via the trigeminal nerve to the ear

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15
Q

What can cause the veins to fill to the point it is a visible distension?

A

Congestive cardiac failure

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15
Q

What nerve provides sensory innervation of the skin to the angle of the mandible and the ear?

A

The great auricular nerve

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15
Q

What nerve supplies the skin of the anterior triangle?

A

The transverse cervical nerve

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16
Q

What is the clinical relevence of the supraclavicular lymph nodes?

A

Malignant disease in the chest or abdomen can present here. Lymphoma or a systemic illness can cause enlargement of these lymph nodes. When removing, beware of CNxi, test function… can the patient shrug?

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17
Q

Where do the cervical lymph nodes drain?

A

The skin overlying the posterior triangle

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18
Q

Where does the eleventh cranial nerve innervate?

A

supplies motor impulses to the trapezius and SCM

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19
Q

describe an extradural haemorrhage

A

this is the rupture of a middle meningeal vessel (artery in particular) causing a haematoma to form. Over hours this can lead to deterioration of consciousness. It is usually caused by a small skull fracture tearing the artery

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20
Q

describe a subdural haemorrhage

A

If the brain is knocked the cerebral veins could break away from the superior sagittal sinus causing blood to build up in the dura mater and arachnoid mater space. This is most likely to affect older people

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21
Q

describe a subarachnoid haemorrhage

A

this is where a cerebral artery aneurysm ruptures causing blood to enter the CSF. Consciousness is lost fast

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22
Q

What is an afferent nerve?

A

a sensory nerve carrying information from body periphery to brain or spinal cord

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23
Q

what is an efferent nerve?

A

a motor nerve carrying information away from the brain or spinal cord to body periphery

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24
Q

what is the innervation of the trigeminal nerve?

A

sensory supplies face and head skin, teeth, oral cavity and most general sensation of the tongue

motor supplies muscles of mastication and some other cranial muscles

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25
Q

what are the sensory divisions of the trigeminal nerve?

A

ophthalmic, maxillary and mandibular

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26
Q

what is the innervation of the facial nerve?

A

sensory supplies skin around the ear and taste sensation for tongue

motor supplies the muscles of facial expression, other cranial muscles, the lacrimal gland as well as submandibular, sublingual and minor salivary glands

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27
Q

What is Horners syndrome?

A

Horners syndrome occurs when there is a lesion somewhere along the pathway of the sympathetic fibres travelling to the head

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28
Q

List four signs/symptoms of Horners syndrome…

A
  • Drooping of upper eyelid on affected side
  • Pupillary constriction on affected side
  • Loss of sweat gland innervation
  • Flushed, warm/dry skin due to vasodilation
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29
Q

What is trigeminal neuralgia?

A

It is a neurological condition characterised by episodes of brief, intense facial pain over one of the three areas of distribution of CNV

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30
Q

What is the cause of trigeminal neuralgia?

A

The cause is uncertain

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31
Q

What can trigger trigeminal neuralgia?

A

Touch or a draft of cool air

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32
Q

What is Bell’s Palsy?

A

It is unilateral facial paralysis with no known cause

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33
Q

What is a potential cause of facial palsy?

A

A result of the herpes simplex virus

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34
Q

What is Parkinsons disease?

A

It is a neurodegenerative disease more common in the over 50’s

It involves low levels of dopamine (a neurotransmitter) found in the basal ganglia (area of the brain involved in movement)

A hallmark sign of Parkinsons is a degeneration of dopamine neurons in the substantia nigra

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35
Q

What is the cause of Parkinsons Disease?

A

The exact cause is unknown but it is thought to be a combination of genetic and environmental factors

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36
Q

What are the symptoms of Parkinsons disease?

A

Tremor (which is worse when a person is at rest)

Slowless of movement

Rigidity

Postural impairment

Non motor symptoms can include cognitive and psychiatric symptoms

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37
Q

What causes a drooping eyelid and loss of sweating?

A

Damage to the sympathetic trunk (Horner’s syndrome)

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38
Q

What are the symptoms of Horners syndrome?

A

Drooping eyelid, loss of sweating, flushed/dry skin, constricted pupil

39
Q

Name a symptom of damage to the sympathetic trunk?

A

constricted pupil, drooping eyelid, loss of sweating

40
Q

What would be a reason for enlarged submandibular lymph nodes?

A

Disease affecting the oral cavity, nasal cavity or maxillary sinus

41
Q

Name some symptoms of a cavernous sinus thrombosis

A

Headache presenting as sharp pain around the eyes

visual problems

High temperature

seizures

42
Q

Describe a cavernous sinus thrombosis

A

Bacteria can pass through the pterygoid venous plexus through the sphenoidal emissary veins to the cavernous sinus. There, bacteria can multiply due to the slow flowing blood.

Symptoms often start 5-10 days after developing an infection in the face or skull such as a boil or sinusitis

43
Q

What muscle protrudes the tongue?

A

genioglossus

44
Q

Which muscle tendon inserts on the coronoid process?

A

Temporalis

45
Q

A patient presents complianing of pain and swelling in the floor of the mouth, especially at meal times. What is the cause?

A

Calculi has formed in the submandibular duct. Pain is caused by the secretion of saliva that cannot flow and so pressure builds up

46
Q

where do the submental lymph nodes drain?

A

Lower teeth, floor of mouth, anterior of tongue

47
Q

Where do the submandibular lymph nodes drain?

A

Lower molars, upper teeth, nose, anterior forehead, sinuses, submandibular and lingual salivary glands

48
Q

Where do the parotid lymph nodes drain?

A

Middle and posterior scalp, temple, ear and parotid gland

49
Q

Where do deep cervical lymph nodes drain?

A

pharynx, tonsils, posterior tongue, hard and soft palate, nasal cavity, thyroid and parathyroid gland

50
Q

where do the superficial cervical lymph nodes drain?

A

skin of the neck

51
Q

what nerve supplies the mucosa of the oropharynx and nasopharynx?

A

the glossopharyngeal, CNix

52
Q

what nerve supplies the pharyngeal constrictor muscles?

A

the vagus nerve (CNx)

53
Q

what nerve supplies the palatoglossus muscle?

A

CNx

54
Q

what is the nerve type and innervation of CNI?

A

CNI; olfactory nerve

sensory

innervates nasal mucosa

55
Q

what is the nerve type and innervation of CNII?

A

CNII; optic nerve

sensory

retina of eye (sight)

56
Q

what is the nerve type and innervation of CNIII?

A

CNIII; occulomotor nerve

motor

innervates muscles of eye

57
Q

name the nerve, foramen by which it exits the cranial cavity and its function

CNI

A

olfactory nerve

cribiform plate of ethmoid bone

sense of smell

58
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNII

A

optic nerve

optic canal

sense of sight

59
Q

name the nerve, foramen from which it exits the cranial cavity and function

CNIII

A

occulomotor

superior orbital fissure

motor supply to muscles of the eye

60
Q

name the nerve, foramen from which it exits the skull and the function

CNIV

A

trochlear nerve

superior orbital fissure

supplys motor function to one muscle of the eye

61
Q

name the nerve, foramen from which it exits the cranail cavity

CNV

A

trigeminal nerve

ophthalmic division exits via superior orbital fissure

maxillary division via foramen rotundum

mandibular division via foramen ovale

62
Q

what are the divisions of the trigeminal nerve?

A

CNV 1 ophthalmic division

CNV 2 maxillary division

CNV 3 mandibular division

63
Q

what are the functions of the trigeminal nerve?

A

general sensation to the face and anterior scalp, the eye, nasal cavity and paranasal sinuses, oral cavity and nasopharynx

proprioception related to bite strength

supply to muscles of mastication and others derived from the first pharyngeal arch

64
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNVI

A

Abducens

superior orbital fissure

abduction of eye

65
Q

name the nerve, foramen from which it exits the cranial cavity and function

CNVII

A

Facial nerve

internal acoustic meatus

motor supply of muscles of facial expression and other muscles derived from second pharyngeal arch

taste sensation for anterior two thirds of the tongue

parasympathetic supply of lacrimal, nasal, submandibular, sublingual and minor salivary glands

66
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNVIII

A

vestibulocochlear

internal acoustic meatus

hearing and balance

67
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNIX

A

glossopharyngeal

jugular foramen

sensory for pharynx. Taste to posterior third of tongue

motor supply to stylopharyngeus

parasympathetic supply to parotid gland

baroreceptors of carotid sinus

chemoreceptors of carotid body

68
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNX

A

vagus nerve

jugular foramen

sensory to interior of larynx, trachea and oesophagus. Taste from region of epiglottis.

Motor to muscles of pharynx and larynx

Parasympathetic supply to thoracic and abdominal vicera

Baroreceptors of aortic arch. Chemoreceptors of aortic bodies

69
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNXI

A

Accessory nerve

jugular foramen

cranial root contributes to vagal function

spinal root supplies SCM and trapezius muscles

70
Q

name the nerve, foramen from which it exits the cranial cavity and its function

CNXII

A

hypoglossal neve

hypoglossal canal

motor supply to intrinsic and extrinsic muscle of the tongue except palatoglossus

71
Q

what areas are innervated by the great auricular nerve?

A

the ear and angle of the mandible

72
Q

where does the submandibular duct enter the mouth?

A

Sublingual papilla

73
Q

which nerve is at risk during surgery to the submandibular duct?

A

the lingual nerve

74
Q

why does laceration to the lib cause excessive bleeding?

A

Rupture of the inferior labial branch of the facial artery where the left and right sides anastomose

75
Q

which muscle is responsible for protrusion of the mandible?

A

the lateral pterygoid

76
Q

what nerve has been damaged if someone is unable to raise/shrug their shoulder?

A

Accessory nerve

77
Q

Which muscle does the accessory nerve supply?

A

trapezius

78
Q

which bones comprise the zygomatic arch?

A

the zygomatic bone and the temporal bone

79
Q

what saliva is produced by the submandibular gland?

A

mixed. Both serous and mucous

80
Q

what saliva is produced by the sublingual salivary gland?

A

mucous secretion

81
Q

what causes the salivary glands to secrete?

A

the parasympathetic nervous system

82
Q

what muscle runs from the hyoid bone to the tongue?

A

hyoglossus

83
Q

what is the action of the hyoglossus muscle?

A

it depresses the tongue

84
Q

what is the origin and insertion of the genioglossus?

A

origin; mental spine

insertion; fans into tongue

85
Q

what is the action of the genioglossus?

A

protrudes the tongue

86
Q

what is the origin and insertion of the geniohyoid?

A

origin; mental spines

insertion; hyoid bone

lies above mylohyoid

87
Q

What are the branches of the maxillary nerve and where do they pass through?

A

The maxillary nerve is one of three branches of the trigeminal nerve, it exists the skull through the foramen rotundum.

Branches from the pterygopalatine fossa;

  • zygomatic nerve through zygomatic foramen
  • nasopalatine nerve through sphenopalatine foramen
  • posterior superior alveolar neve
  • greater and lesser palatine nerve
  • pharyngeal nerve

There are also branches from the infraorbital canal;

  • middle superior alveolar nerve
  • anterior superior alveolar neve
  • infraorbital nerve
88
Q

Name the origin, insertion, action and nerve supply for the masseter

A
  • Origin; zygomatic arch
  • Insertion; lateral border of and angle of mandible
  • Action; elevates the mandible

can be tested by clenching jaws

Nerve; masseteric branch of mandibular division of trigeminal nerve

89
Q

Name the origin, insertion, action and nerve of the Temporalis

A
  • Origin; floor of temporal fossa
  • Insertion; coronoid process and anterior border of ramus
  • Action; elevates and retracts the mandible

Nerve; deep temporal nerve, branches of the mandibular division of the trigeminal

Can be tested by clenching teeth and palpating

90
Q

What is the origin, insertion, action and nerve supply of the lateral pterygoid?

A
  • Origin; lateral surface of lateral pterygoid plate
  • Insertion; anterior border of the condyle and intra-articular discs
    i) inferior belly attaches to head of condyle
    ii) superior belly inserts into the intra-articular disc
  • Action; protrudes and laterally deviates the mandible. Inferior head funcitons with mandibular depressors during opening
  • Nerve; nerve to lateral pterygoid branch of mandibular division of trigeminal nerve

Cannot test through intra/extra oral exam but can test response to resisted movement

91
Q

What is the origin, insertion, action and nerve supply for the medial pterygoid?

A

-Origin; deep head to the medial surface of the lateral pterygoid plate and superficial head to tuberosity of maxilla

Insertion; medial surface of angle of mandible

Action; elevation and protrusion of mandible

Nerve; nerve to medial pterygoid of mandibular branch of trigeminal nerve

cannot test through intra/extra oral exam

92
Q

Describe where the mental foramen is located

A
  • it is located on the anterior surface of the mandible. It transmits the terminal branches of the interior alveolar nerve and mental artery
  • It is located roughly between the first and second permanent lower premolars
  • It provides sensory innervation to the buccal soft tissue anterior to the mental foramen, lip, and the chin, and the anterior teeth on that side of the arch
93
Q

What nerve is the mental nerve a branch of?

A

A branch of the inferior alveolar nerve

94
Q

Describe three differences between a stroke and a facial palsy

A

*LA causes palsy on the same side

*Stroke causes palsy on the opposite side

*stroke - can still wrinkle forehead on affected side

95
Q

A dentist causes a facial palsy as a result of an IAN block. The patient has a sore TMJ. How was this palsy caused?

A

If bone is not hit and the needle passes too far posteriorly, LA is deposited in the parotid gland. The facial nerve runs through it, and due to the dense fascia around the gland, the LA will remain for a long time and cause paralysis of the facial muscles that the nerve innervates

96
Q

Explain why a patient who has had a stroke can still wrinkle their forehead, but a patient with a facial palsy cannot

A

A) The innervation to the muscles of the upper face originates on both sides of the brain, whereas the innervation to the muscles of the lower face comes from the opposite side of the brain only. B) When the cortex is injured, there’s weakness in the contralateral lower face only. C) When the facial nerve is injured, there’s weakness in the ipsilateral upper and lower face.

97
Q

Give three ways you could manage a patient with a facial palsy

A

*Reassure the patient.

*Tell them the sensation will return after a few hours.

*Use an eyepatch to prevent the eye from drying out/protect from dust etc as pt cannot blink

*

3rd year dentistry (16 decks)

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